Provider Demographics
NPI:1518620020
Name:MENDEZ FLORES, GABRIELA (MSW)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:MENDEZ FLORES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 37 BOX 7493
Mailing Address - Street 2:
Mailing Address - City:GUANICA
Mailing Address - State:PR
Mailing Address - Zip Code:00653-9801
Mailing Address - Country:US
Mailing Address - Phone:787-508-0778
Mailing Address - Fax:
Practice Address - Street 1:CARR 14 BO MACHUELOS PREDIOS SAN LUCAS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00732
Practice Address - Country:US
Practice Address - Phone:787-840-6630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR237481041C0700X
PR156961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical